Laryngeal Photos: Inflammation

Leukoplakia

Leukoplakia is a white patch on the vocal fold. It may be from any irritation such as reflux or smoking.

Leukoplakia covers not only the vocal cords, but also the interarytenoid area as well.

Granuloma

Granulomas are typically located over the vocal process of the arytenoid cartilage. They may be caused from intubations during anesthesia or from vocal trauma (typically speaking at too low a pitch). Click on the photo to see a range of types of granulomas.

Fungal

Left: Patient with hoarseness (treated extensively with anti-reflux medication) who was using an Advair inhaler. The left cord is swollen with a white patch on it.

Right: After 30 days treatment with fluconazole and stopping the steroid inhaler the voice and vocal cords have returned to normal.

Fungal infection from steroid inhaler. This is most common in asthmatic patients dependant on steroid inhalers.

A more extensive fungal infection from a steroid inhaler. Candida is the most common organism.

When one's immune system is suppressed by something like chemotherapy, a fungal infection may be quite extensive.

A fungal infection called coccidomycosis that is from California's Central valley.

Bacterial infection

Left: A bacterial infection of the larynx is very serious as the swelling can nearly close off the airway in an adult and easily closes off the airway in a child. It is typically called epiglottitis or supraglottitis. The danger lies in the softness of the tissue which can easily expand, particularly the loose tissue of the arytenoids can be drawn in during inspiration. Here the arytenoids are very swollen and limiting the opening of the vocal cords.

Right: After two days of antibiotics and some steroids, the swelling (and pain) has greatly improved.

Viral infection

Left: This is the common winter cold. The vocal cords are pink and swollen, the voice deep, the secretions thick.

Right: The vocal cords have returned to normal

Laryngitis sicca

Laryngitis sicca, or laryngeal dryness is a condition for which I have not found a cause nor have I found a solution. Some people have speculated that it is an autoimmune phenomenon, but I have not been able to confirm that.